ABORTIONS
DEFINITION
Abortion is the ending of a pregnancy by removal or expulsion of an embryo or fetus before it can survive outside the uterus. An abortion that occurs without intervention is known as a miscarriage or spontaneous abortion
Abortion can be either spontanoues or induced.
causes
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Infection.
Medical conditions in the mother, such as diabetes or thyroid disease.
Hormone problems.
Immune system responses.
Physical problems in the mother.
Uterine abnormalities
foetal causes
foetal abnormalities that are incompatible with life such as enencephaly
multle pregnancies
a foetus with ABO boold incompatibility
martenal causes
hormonal imbalances where there is a sudden drop in progesterone level
retroversion of the uterus/ double uterus
an incomplete cervix.
trauma to the abdomen or pelvis
Acute maternal infections
uterine tumours such as fibroids or cysts
pathophysiology
For abortion to occur the uterus must contract, following a stimulus such as blow to the abdomen, uterine contractions can start spontanoeusly. then there is presence of blood gush/ oozw depending on the stage of the condition. the cervix remain closed, that stage is said to be threatening. It becomes inevitable when uterine contractions strengthen, vaginal bleeding increases and the cervix becomes soft and progressively dilates. there is uterine expulsion of the foetus, placenta and membranes.
complet expulsion of the products of conceptions id said to be comple abortion while reatined products of conception are said to be incomplete pregnancy.
types of abortions
spontanoeus abortion- involuntary termination of pregnancy with no apparant reason or warning. It can be either threatened or inevitable.
Induced abortionthe termination of pregnancy using drugs or surgical intervention after implantation and before the embryo or fetus has become independently viable-
nursing management
provide privacy
provide emotional support
provide mechanism of copying and medication to relieve pain.
check pad every 15 minutes and record results
observe, examine, record and report expelled products of conception
assessment and common findings
on examination they may be pyrexia following infection
hypothermia due to pain
blood loss or shock
on palpation the fundal height above the sympisis pubis
patient may test postive for pregnancy
if termination is inevitable , internal, vaginal examination may reveal frank vaginal bleeding and a soft open cervix.